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CNN SATURDAY MORNING NEWS

Weekend House Call

Aired November 15, 2003 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

HEIDI COLLINS, CNN ANCHOR: Now we turn to Weekend House Call with Dr. Sanjay Gupta.
It begins right now.

DR. SANJAY GUPTA, CNN CORRESPONDENT: Good morning and welcome to Weekend House Call.

This morning we're talking about new treatments to keep your heart healthy. Heart disease is the number one killer of men and women in America and this week thousands of researchers got together at the American Heart Association meeting to find out the latest developments in treating this deadly disease.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Severe heart failure brings severe symptoms -- shortness of breath, difficulty walking -- all because the damaged heart is too weak to pump enough blood to serve the body's needs. Now, a new study on experimental therapy may offer hope to those with failing hearts. The therapy uses stem cells that appear to change damaged heart muscle into healthy, working tissue.

DR. WILLIAM BOZEMAN, WAKE FOREST UNIVERSITY: We're taking the patient's own cells to put back into their own heart so they're not rejected.

GUPTA: So this is what happens. Approximately 30 million stem cells taken from the patient's own bone marrow are injected directly into the part of the heart that is damaged. Doctors are still trying to figure out exactly why it works.

BOZEMAN: My best guest is that selected stem cells differentiate into heart muscle cells and blood vessel cells directly over a period of days to weeks.

GUPTA: On the left, shown in red, is an image of a severely impaired heart that pumps poorly. On the right is the same heart four months after treatment. The colors indicate that the heart is contracting more forcefully.

BOZEMAN: They could walk better. They were less short of breath. They had more energy. Some of them were able to return to their jobs.

GUPTA: A second experimental heart treatment could help those in a moment of true crisis, sudden cardiac arrest, where the heart stops beating and patients collapse.

UNIDENTIFIED MALE: The sad truth is that 95 percent of these people die.

GUPTA: Looking for a solution, doctors conducted a small study using a fact acting clot busting drug given after patients had failed to be revived with CPR, a defibrillator and standard medications.

UNIDENTIFIED MALE: The survival from cardiac arrest is only about five percent with the standard interventions. We added another four percent on top of that.

GUPTA: Clot busting drugs work by dissolving the clot or blockage that may be cause the person to have a heart attack in the first place. The main risk? Increased bleeding, which can lead to a stroke. Larger studies are being planned in the hopes of adding more weapons in the battle against heart disease.

(END VIDEOTAPE)

GUPTA: And that battle is not just about treatments, but also prevention. New studies came out at that same meeting showing, for example, air pollution increased a person's risk for having a heart attack, especially in the case of smokers. And people whose blood pressure goes up from mental stress are six times as likely to have a heart attack, as well. Another study showed older men with few relationships may have an increased risk of heart disease.

And maybe most frightening to parents, researchers found the early signs of heart disease in one of eight children that were studied in rural North Carolina. Study authors say obesity may also be one of the problems.

We've got a lot to talk about today. Lots of things with heart disease. Give us a call. We want to hear from you, 1-800-807-2620. E-mail us, housecall@cnn.com.

And to help us sort through all of this, Dr. Mehmet Oz is rejoining us. He's back this morning from New York. He's the director of the Cardiovascular Institute at Columbia University Medical School. He also has a series on the Discovery Channel called "Second Opinion with Dr. Oz."

Good morning, doctor.

I've got to tell you, I watched your show. I thought it was terrific.

DR. MEHMET OZ, PROFESSOR SURGERY, COLUMBIA UNIVERSITY: Thank you very much, Sanjay.

I watch you a lot more than you watch me.

GUPTA: I've got to ask you real quick before we start, what's the most important organ, the heart or the brain? OZ: Well, the heart, the neurosurgeons, your specialty, always argue the heart's only there to pump blood to the brain. But many heart surgeons are beginning to think the brain is in the heart. Certainly the poets would agree with us.

GUPTA: That's right. The seat of the soul.

Listen, you were at the heart conference that we were just talking about.

What was the biggest news that came out of it for you?

OZ: I think the biggest news was the stem cell story. It's interesting because for most of Western medical history, we have believed that the heart could not regenerate itself. Once injured, it was done. And we learned at this heart meeting that there were several different ways we could take bone marrow cells -- these cells that are designed to recreate new elements of the body that are damaged can actually enter the heart and change the ability of the heart to respond to injury, in particular a heart attack.

You mentioned one wonderful example in heart failure. But for me the more compelling story was if a patient's having a heart attack, once you open that blood vessel, frequently the damaged muscle doesn't recover. There's been so much injury that you can't clean out the debris, you can't lay down a plot form for new muscle growth.

By injecting cells soon after a heart attack, we may change the natural history of the leading killer of man and womankind.

GUPTA: That is really remarkable. And just to be clear, you know, when people think about heart disease typically they think it's irreversible. We're going to be talking about that. After someone's had a heart attack, you can do a heart operation to prevent them from getting worse. But this could actually be reversing some of that.

Lots of questions about this as you won't be surprised by, Dr. Oz.

Let's go ahead and start with Karl in Wisconsin, who asks, "I recently read an article mentioning alpha lipoic acid and aceytl-L- carnitine and the possibility that these drugs together could improve circulation in a cardiovascular patient. Do you have any thoughts on this?"

And, you know, we're talking about anti-oxidants, Dr. Oz, here.

What do you think about that, non-invasive sort of things?

OZ: Well, alpha lipoic acid is an anti-oxidant that is both water and lipid soluble. So it's sort of like taking Vitamin C and Vitamin E together. It's a particularly powerful anti-oxidant and we know that as we age, the oxidation process around us -- and that happens from being exposed to the sun or flying at 35,000 feet or even being under stress -- all these oxidative forces damage the lining of our cells, but they also damage the proteins within the cells. So by taking supplements like alpha lipoic acid, we can probably reverse or slow down that process. Of course, these studies are very expensive to do and the vitamin manufacturing companies are unable to invest those types of funds to actually prove in large studies how effective they are.

But I must say, I tell my family that alpha lipoic acid is a pretty good idea.

GUPTA: I was going to just ask you. And you're a cardiac surgeon. A lot of people sort of want to keep behind the curtain, do you do these sorts of things? Do you take these antioxidants?

OZ: I do take antioxidants and I must say that my wife's family, the Limoles (ph), who are well known in this arena, have taught me a lot. My father-in-law, who is a heart surgeon, as I am, has experimented quite broadly in these areas and I share his enthusiasm for believing we can do a little better than just using mechanical solutions. And, in fact, these subtle supplements, things that we actually used to find in our food chain but now have a difficult time obtaining, can change dramatically our ability to recover from injury and deal with the aging process.

GUPTA: That's fascinating. As long as it doesn't put you out of business, though, right?

Sharon from Tennessee -- we've got another e-mail coming in, doctor -- Sharon from Tennessee writing, "When do you think the new medication Exanta will be available in the United States?"

And for people who don't know, Exanta is an anti-coagulant and, you know, people think about aspirin, using aspirin to try and cut down on heart attacks and strokes. What about Exanta? Is that something that's going to be here soon?

OZ: Well, Exanta is going to be here next year and it really will change dramatically the way we think about thinning our blood. In fact, it's not really a competitor to aspirin, which is a relatively safe product. But it's really a competitor for cumidin. Now, cumidin, which is used to thin blood throughout the country, is really rat poison. Rats take the cumidin, they thin their blood too much and because they have very high blood pressures, they bleed into their brains.

Amazingly, we use lower doses, but nevertheless the exact same drug to thin the blood, patients who have heart valves, irregular heartbeats or have other challenges with their blood veins.

So if we can use a drug like xx, which is a much safer alternative, we think, it could make this process much safer and much easier.

GUPTA: That's good advice. And cumidin, of course, rat poison. But a lot of people taking that quite safely still at home. Don't get too concerned about that.

High cholesterol and high blood pressure are major risk factors for heart disease, as well.

Coming up, we're going to take a look at some research promising one drug actually reduces the amount of plaque in your arteries, maybe a small amount, but it still does it. We're also going to talk about heart stents. Are some better than others?

Don't forget to give us a call. That's 1-800-807-2620. E-mail us, housecall@cnn.com.

Also, we're just about 10 days away from the busiest shopping day of the year. Are you already getting stressed out about the holidays? From spending too much to dealing with the in-laws, e-mail us your questions on that, as well, housecall@cnn.com.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: Well, welcome back to Weekend House Call.

We're talking about new heart treatments. A study out this week compared two popular cholesterol fighting drugs, Lipitor and Pravachol. Most of you have probably heard of these. Lipitor stopped plaque from developing and also lowered LDL, also known as bad cholesterol, more so than Pravachol. In a very few cases, in fact, Lipitor actually seemed to reverse the amount of plaque already in the arteries, reversing heart disease.

This is potentially very big news if it holds up under more testing. It's the first time a cholesterol lowering drug has revised plaque buildup.

Plus, last week researchers also say they may have found "Drano" for the arteries. Drano being an experimental drug which simulates a super sized form of your good cholesterol and seems to reduce plaque deposits in your arteries, as well.

We're talking with Dr. Mehmet Oz. He's a cardiac surgeon at Columbia Presbyterian Hospital in New York City.

He also has a show, a very good, one, as well.

Lots of questions coming in on this, Dr. Oz.

Let's go straight to our first one.

Beth from Ohio asks, "Will they ever come up with an alternative to bypass surgery? It's hard to believe there is still no drug that dissolves cholesterol and clogged arteries."

Doctors, I should add, these new studies that show that these drugs actually reversing plaque, could that potentially be an answer to this, Dr. Oz?

OZ: Well, I think Beth's right on target. The reality is we should be smart enough to find the equivalent of Drano. But let's just repaint the picture. Most Americans think that what causes a heart attack is the plaque inside the blood vessels of their heart. And although that's part of the story, really what causes the damage and often causes strokes, as well, as you know, is the clot that forms on top of these plaques.

So it's a two part answer. First, how do we reduce the plaques. Well, drugs like Exanta that we just mentioned, cumidin and aspirin are wonderfully effective at that. But on the plaque side, we actually are finding the equivalent of Drano now and this new study released this week talked about a small town just next to Lake Garda in Italy, outlined a series of families that have very low HDL levels but don't have any plaque.

It's a wonderful science success story because doctors went in there, they figured out why these people seem to be protected from having heart attacks. They made this product into a drug and they gave it to a series of patients and actually were able to reduce, albeit only by four percent, nevertheless, reduce the amount of plaque in a blood vessel.

This is a huge story for us in heart disease because it's one of the first times we've ever been able to use HDL, which is the most powerful protector of our heart -- because HDL is like Mighty Mouse, it carries the cholesterol away from the plaque -- and we've shown that it can actually, should be effective.

GUPTA: That's very interesting. And we, more questions on that.

Let's go straight to Georgia from North Carolina.

Good morning, Georgia.

Welcome to House Call.

GEORGIA: Good morning.

GUPTA: What's your question for us today?

GEORGIA: I'm wondering about the cholesterol lowering drugs. I tend to run a high cholesterol. The last test was non-fasting, 276 total cholesterol. And I've had very bad side effects to the leading cholesterol drugs. I'm unable to tolerate them.

GUPTA: What happens when you take them?

GEORGIA: Extreme leg cramps and I have developed varicose veins terribly in both legs and feet.

GUPTA: Huh. Is that something, first of all, those side effects, Dr. Oz, is that something that you hear of?

OZ: Well, muscle cramps are very, very common with the cholesterol lowering drugs and it's a challenge for all of us in medicine to be able to cope with. But, Georgia, I have a couple bits of advice. The first thing is, like many Americans, you're fixated on the cholesterol level and although that's an easy number to remember, that's not where the game is won and lost. The reality is it's how the cholesterol is carried, whether it's good or bad proteins that carry it, LDL and HDL, and, in addition, is cholesterol oxidized or not?

You know, we really need cholesterol. That's the plaster that seals our blood vessels when we injure our blood vessels. So if you have high blood pressure or if you smoke -- which you shouldn't do -- or if you have other things that cause injuries to the blood vessels, the cholesterol is valuable to you.

But if you get your cholesterol from better sources like olive oil, which is a monounsaturate, or sources of omega 3 fats like fish oils and flax seed oils, these are healthy cholesterol building oils. So that the total cholesterol level is not quite as dangerous to you.

GUPTA: That's good advice. Let me just ask you one thing, sort of bouncing off that, as well, Dr. Oz. Who shouldn't take these statin drugs now? I mean obviously maybe there's an age where you're too young to take them. But it seems like they're so good, relatively few side effects. They may make you live longer, cut down on your cholesterol as well as these plaques. Why shouldn't everyone be taking these drugs?

OZ: Well, there are many scientists who argue that Lipitor should be in our water and that we should take cholesterol lowering drugs in all of our foods as a supplement. But I think it's a little bit of a cop out. The reality is our bodies are designed to function by eating healthy foods and processing them in a natural way. By relying on drugs to deal with your dietary indiscretion, I think you're actually going to fool yourself. You can't have a hot dog and sprinkle Lipitor on it or Pravachol or any other great drug and expect to come out with the same result as another individual who pay attention to what they're eating and becomes aware of the most precious thing they've ever inherited, their body.

GUPTA: Dr. Oz reminding viewers to go ahead and eat your broccoli.

OZ: Exactly.

GUPTA: Remember to do that.

Judy from Connecticut, good morning and welcome to Weekend House Call.

JUDY: Good morning.

My question, how common is it to have heart disease and not even know it? My son-in-law, who's only 50 and would seem to be very healthy, just had to have an angioplasty. They discovered a major descending artery was 90 percent blocked with plaque and her only warning signal was acid reflux.

GUPTA: Hmmm, that's...

OZ: Well, Judy, the blockage she has is actually called a widow maker. And in her case, I guess it's a widower maker. But they're very dangerous. The unfortunate reality is that half of Americans who have a heart attack never knew they were going to have one. The reason that it's the leading killer of all Americans is not because we're stupid. We just don't have the kinds of typical symptoms, the chest pressure, the sweating, the kinds of warning signs that we expect to have.

In fact, amazingly, the heart doesn't really sense pain. You feel pain or discomfort because the nerves from your heart cross other nerves in your spine as they go back to the brain. So it's not surprising that she didn't have any warning symptoms.

It's one of the reasons I actually endorse exercise in older people, because if you take care of your body and push it and exercise it, you will notice subtleties that may tip you off to the fact that you're about to have a life threatening heart attack.

GUPTA: We're talking to Dr. Mehmet Oz from New York, a cardiac surgeon up there.

When we come back, is there one thing you can eat that will help you keep your heart healthy?

Next, also, we're talking about how your diet can affect your heart, from how much alcohol you drink to what kind of choices you make at the dinner table.

Stay with us.

(COMMERCIAL BREAK)

GUPTA: Welcome back to Weekend House Call.

We're talking about keeping your heart healthy. One way is to watch those risk factors we just showed you. Some you obviously can't control, like your age or hereditary. But others, like smoking or being overweight, is something we can all work on.

With us, helping us sort through all this, cardiac surgeon Dr. Mehmet Oz. He's out of New York.

Lots of questions. You probably get these all the time. Lots of questions and calls coming in for you this morning on this topic, so let's jump right back in.

Kevin in Hawaii asks, "Which one food or beverage is the best for the heart, alcohol included?"

Good question, Kevin.

What do you say, Dr. Oz?

OZ: Well, many would argue that red wine is an ideal food, but, of course, you can't live on red wine alone, and unfortunately some people don't drink it in moderation. So I think the best foods, by far, are the leafy green vegetables -- the broccoli, the kale, the foods that are rich in vitamins, phytoestrogens, magnesium, the kinds of things we need to really build substance in our bodies.

Now, how you preserve the food is obviously important, as well. And if you can't, it's not quite worth as much. But fresh, green leafy vegetables I think are the best basic food.

But if you're talking about a meal, the best meal you can have -- and, Kevin, you're in Hawaii, you should be able to do this very easily -- is that oily fish like a salmon, a young fish, not an older fish, so that it doesn't have as many toxins in it, combined with leafy green vegetables. That's the perfect meal.

GUPTA: OK, let's go straight to our next e-mail. I think we've got an e-mail from Joseph in New York, who's writing -- actually, Patricia in Colorado. Let's go down to Patricia in Colorado. "If during aerobic exercise" -- this is a good question -- "your heart rate goes way over the charts' recommendations, what does this do to your heart and your workout?"

You know, and people ask me this all the time, as well, Dr. Oz. They say, OK, the monitor says I'm supposed to get up to about 160 and I look down at the monitor on my treadmill or Stairmaster and it's 180. Is that particularly bad? Does that mean something bad is going on with your heart?

OZ: Well, Patricia, it often means you're just fine and you're exercising a little past your normal regular comfortable rate. But you need to be cautious about a few things. First of all, the heart first deals with stress with pushing itself by pushing more blood out, by contracting more efficiently. And, remember, the heart pushes blood out not like a balloon emptying air, but rather the way a towel empties water out when you wring it.

So as the heart wrings the blood out, it will start to beat faster if it's deconditioned. So if you're out of shape, you'll find your heart rate increasing faster.

But you also need to be cautious that your heart rate is actually regular, because frequently people start having irregular heartbeats if they're older and they begin exercising too abruptly. And that does require some type of monitoring.

GUPTA: So if you think you're in pretty good shape and your heart rate is still going pretty high, you may want to get that checked out, get an EKG or something.

Let's try and see if we can squeeze one more e-mail in here. Larry from West Virginia writing, "I am 60 years old, I'm about 40 pounds overweight, fairly active and generally would call myself healthy, except for slightly elevated blood pressure. My family doctor said a cholesterol test was unnecessary when I went in for a routine physical. My other blood work was apparently OK. Is cholesterol testing overrated?"

Dr. Oz, what do you say about that?

OZ: Well, I think cholesterol testing is definitely overrated and the reason I use cholesterol testing is a wake up call to the patient. It seems, for example, for ultra fast C.T. scans, the calcium detecting scans for the heart, it doesn't tell us that you have heart disease and it's not a very sensitive measure for us to identify people who are at risk. But it's a wake up call.

So I think you should have your cholesterol checked, find out where you are and use it as a guide, not because it's going to save your life, but because it will bring awareness to you and those around you about how important your body lipids are.

GUPTA: We're going to get some final thoughts from Dr. Oz when we return.

Grab a pen, also. When we come back, we're going to tell you where you can go to get all these studies we've been talking about. Some of you want to do some of your own research at home.

Plus, we're also going to give you a quiz to check out your cardiac health.

First, here's some of this week's medical headlines in today's For Your Health update.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): An outbreak of Hepatitis A in western Pennsylvania made over 300 people sick this week. Public health workers say that all of the ill patients ate at a Chi-Chi's restaurant in Beaver County. The CDC is investigating the source of the outbreak, but says it could be poor hygiene among food workers. This marks the largest outbreak of Hepatitis A in U.S. history.

Also, a study out of Emory University suggests that the popular anti-tuberculosis drug Seromycin may help people deal with phobias. The drug, when combined with a series of virtual reality treatments, resulted in patients overcoming their fear of heights after only two sessions. That's six fewer than the usual course of eight treatments.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

(INTERRUPTED FOR COVERAGE OF LIVE EVENT)

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